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Organization

HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC

Active
Parent organization
HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC
Other names
Canton/LaGrange Family Practice
Organization subpart
Yes

Provider details

NPI number
Legal business name
HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC
Authorized official
ROB GASAWAY (VP OF FINANCE)
(573) 406-1608
Entity
Organization

Contact information

Practice address
1802 ELM ST, CANTON, MO 63435-1694
(573) 655-4891
(573) 288-5361
Mailing address
6500 HOSPITAL DR, HANNIBAL, MO 63401-6890
(573) 221-3415

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
590416004
MO
Enumeration date
07/18/2006
Last updated
05/25/2021
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